Provider Demographics
NPI:1902915929
Name:PITRE, REED M (MD)
Entity Type:Individual
Prefix:
First Name:REED
Middle Name:M
Last Name:PITRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:REED
Other - Middle Name:MICHAEL
Other - Last Name:PITRE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:424 DECATUR ST SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-1848
Mailing Address - Country:US
Mailing Address - Phone:678-843-8600
Mailing Address - Fax:678-843-8501
Practice Address - Street 1:424 DECATUR ST SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1848
Practice Address - Country:US
Practice Address - Phone:678-843-8600
Practice Address - Fax:678-843-8501
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0497072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
26BDJWKMedicare ID - Type Unspecified
H43543Medicare UPIN